Home Top Stories Design an offer that will satisfy insurers and 1.5M employees

Design an offer that will satisfy insurers and 1.5M employees

39
0
Design an offer that will satisfy insurers and 1.5M employees

Although there is no deadline for knowing the new tender, sources from the ordering ministry Oscar Lopez They indicated to EL ESPAÑOL-Invertia that they would prepare it “with agility“The Government’s objective is to ensure that this model, which serves 1.5 million civil servants, does not decline.

But to do this, you must present an offer consistent with insurers’ claims. The latest funding proposal was described by businesses as “insufficient”. It is for this reason that they refused to appear at the concert which was to take effect in January 2025 and which was to last two years.

More specifically, last October, the Executive approved a new agreement which provided for a 17.12% increase in premiums. The total amount of the contract amounts to 1,337,059,970 euros in 2025 and 1,344,553,098 euros in 2026. This represents 303.9 million euros more compared to the last year of validity of the previous agreement.

The increase in financing offered (and refused by companies) is distributed by 16.5% in 2025 and 0.62% in 2026. With this increase, the average premium per mutualist per year increased from 1,032.12 euros to 1,208.81 in 2026.

A figure very far from the claims of the insurance sector. Companies that provide healthcare under the auspices of Muface (SegurCaixa Adeslas, Asisa and DKV) They asked for a 40% increase. For its part, the mutual offered 24%.

With the agreement in force, the three insurers combine losses worth 470 million eurosaccording to DKV calculations. A few red numbers this would also happen in the next concert with the current financing proposal, as warned by the company of which Fernando Campos is CEO.

As the new call for tenders arrives, Muface assured that all mutual members, both owners and beneficiaries, “will continue to receive the same health care they benefit from under current conditions”.

The Ministry of Digital Transformation and Civil Service told this newspaper that contract law allows the service to be extended when another tender is awaiting approval. Therefore, the continuity of Coverage is guaranteed until the concert is renewed.

What happens if Muface disappears?

The decision of SegurCaixa Adeslas, Asisa and DKV to withdraw from Muface leaves this health model in limbo. Even though it still exists a second chance to save mutuality, what would happen if it disappeared?

Public health would have to take charge of the health care of 1.5 million civil servants, which would involve a an economic impact of more than 1,000 million euros and the inevitable increase in waiting lists.

The report Administrative mutualism: Predictive model on the choice of mutualists and future scenarioscarried out within the framework of the Chair of Sustainable and Responsible Health of the Complutense University of Madrid, represents an increase of 266% of outpatient lists and 115% for surgical intervention. In terms of infrastructure, the public system would need almost 4,000 additional beds.

Also The Ministry of Health carries out an analysis of the impact that the passage of these officials would have on public health if Muface ended up declining. “If the negotiation process does not bear fruit, public health will strive to offer the best continuity of care“, they emphasized from the department headed by Mónica García.

The impact on private healthcare

The end of Muface would not only affect public health. This would also cause losses for the insurers. According to calculations included in the aforementioned report, insurance companies they would lose 14% of their turnoverwhich represents 1.7 billion euros.

Meanwhile, suppliers of services hospital They would see their income reduced by 8%, or around 1,000 million euros. This would endanger the continuity of the centers, mainly in regions like Castilla-La Mancha, Extremadura and Castilla y León.

LEAVE A REPLY

Please enter your comment!
Please enter your name here